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Ask Dr. Sears: Stop Thumb Sucking

QMy 2-year-old is sucking her thumb, and I can see that her teeth are starting to protrude from it. Can you suggest any remedies to break a toddler from this habit?

A.Thumb sucking is a natural instinct. When I look at ultrasounds, I see many babies sucking their thumbs in the womb. Sucking soothes sore gums during teething, and is often a baby's first way to self-calm. During the first year, smart infants figure out that non-nutritive sucking (sucking without feeding) settles upset tummies by activating the flow of saliva.

Because infants associate sucking with pleasure, they continue the habit throughout toddlerhood, and revert to it especially during times of stress. This need to suck usually diminishes sometime during the first year. Some toddlers, however, retain thumb or finger sucking as a normal method of using their body parts for pleasure or relaxation.

The good news is that by the time a child is old enough that thumb sucking might harm her teeth, she should also be old enough to understand how it is harmful. Be sure your child has regular dental check-ups every six months to a year, and try these five tricks to keep her habit from becoming a problem:

Keep little thumbs busy

Bored little thumbs and fingers often find their way into the mouth. The time-honored way of breaking any annoying or harmful habit is "distract and substitute." As soon as you see the thumb going toward the mouth, quickly distract your child into a hands-on activity or insert a toy into both hands.

Offer a sub

Tell your daughter: "When you feel like sucking your thumb, squeeze your thumb instead of sucking it." Or play the game of hide the thumb: "As soon as you feel like sucking your thumb, wrap your fingers around your thumb and hide it." Giving your child something else to do with her hands can change a harmful habit into a harmless one.

Track the trigger.

Try to identify which situations set off her thumb sucking. Is she tired, bored, or stressed? Eliminate as many triggers as possible and quickly intervene with a play activity to ward off the thumb sucking.

Play show and tell

In front of a mirror, have your child run her index finger over the protruding upper teeth and put her fingertip in the gap between the upper and lower teeth while she bites. Put on a big smile and protrude your own upper teeth outward, saying something like: "You could develop Bugs Bunny teeth if your thumb keeps pulling on your upper teeth. But, if you don't suck your thumb so often and pull on them so hard, you'll have pretty teeth and a pretty smile." And then put on your pretty smile.

Let the thumb rest at night

In my pediatric practice experience, the most severe cases of overbite occur in those who strongly suck their thumbs throughout the night. Discourage her from going to sleep when sucking her thumb, as she will tend to revert back to this comfortable sucking habit when she wakes up. Some other tips:

* Give her a teddy bear that's so big she'll have to wrap her hands around it.

* Put her to bed with her hands occupied with a book or toy.

* Set up alternative sleep-inducing props, such as lullabies and music. Make a medley of you singing your child's favorite sleep-inducing lullabies, and let it continuously play throughout the night. If your child is comfortable going to bed with this music, she is more likely to resettle with the music rather than her thumb when she wakes up.